动脉僵硬度与心房颤动事件的关联：一项队列研究。
Association of arterial stiffness with incident atrial fibrillation: a cohort study.
机构信息
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Department of Medicine, Division of Cardiology, Emory School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA.
出版信息
BMC Cardiovasc Disord. 2021 May 20;21(1):247. doi: 10.1186/s12872-021-02057-8.
BACKGROUND
Stiff arteries increase left ventricular (LV) end-systolic workload, leading over time to left atrial and ventricular remodeling, and providing the substrate for atrial fibrillation (AF) development. We investigated if carotid femoral pulse wave velocity (cfPWV), a measure of central arterial stiffness, is associated with incident AF.
METHODS
In 2011-2013, cfPWV was measured in 3882 participants of the Atherosclerosis Risk in Communities Cohort Study (ARIC) without prevalent AF. Participants were followed through 2017 for the incidence of AF. Individuals were categorized in cfPWV quartiles based on visit measurements. Multivariable Cox regression models were used to evaluate the association of cfPWV with incident AF.
RESULTS
Mean age was 75 years (SD 5), 60% were female and 20% were African American. Over a median follow-up of 5.5 years we identified 331 incident cases of AF. cfPWV demonstrated U-shaped associations with AF risk. In models adjusted for age, race, center, sex, education levels, and hemodynamic and clinical factors, hazard ratios (HR) of AF for participants in the first, third and fourth quartiles were 1.49 (95% CI 1.06, 2.10), 1.59 (1.14, 2.10), and 1.56(1.10, 2.19), respectively, compared to those in the second quartile.
CONCLUSION
Among community-dwelling older adults, low and high central arterial stiffness is associated with AF risk.
背景
僵硬的动脉会增加左心室（LV）收缩末期的工作量，随着时间的推移导致左心房和心室重构，并为房颤（AF）的发展提供基础。我们研究了颈动脉-股动脉脉搏波速度（cfPWV），一种衡量中心动脉僵硬程度的指标，是否与房颤的发生有关。
方法
在 2011 年至 2013 年期间，对无房颤的社区动脉粥样硬化风险研究（ARIC）的 3882 名参与者进行了 cfPWV 测量。通过 2017 年的随访，评估了 AF 的发生率。根据就诊时的测量结果，将参与者分为 cfPWV 四分位组。采用多变量 Cox 回归模型评估 cfPWV 与房颤发生的相关性。
结果
平均年龄为 75 岁（标准差为 5），60%为女性，20%为非裔美国人。在中位随访 5.5 年期间，我们共发现 331 例房颤病例。cfPWV 与房颤风险呈 U 形相关。在调整年龄、种族、中心、性别、教育水平以及血液动力学和临床因素的模型中，cfPWV 处于第一、第三和第四四分位数的参与者发生房颤的风险比（HR）分别为 1.49（95%CI 1.06，2.10）、1.59（1.14，2.10）和 1.56（1.10，2.19），与第二四分位组相比。
结论
在社区居住的老年人中，低和高中心动脉僵硬与房颤风险相关。
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